December 08, 2005
Will the Donut Hole Save the Democrats?
I find myself at odds with conventional liberal wisdom in the debate over the new Medicare prescription drug plan. Democrats are banking on confusion about the plan's intricacies to generate an elderly backlash that will turn into votes in next year's mid-terms. Remember Dan Rostenkowski fleeing angry oldsters? Remember the Hilary-care and the '94 election? Is the Bush drug plan next? I don't think so.
The Republican plan is fatally flawed. It forbids the government from negotiating prices the way the Veterans Administration and any respectable insurance plan does. It has limited ability to place restrictions on buying drugs that have cheaper substitutes whether brand name or generics. There's a huge gap in coverage when drug costs go over $2,500 (the so-called donut hole).
But bottom line is that for the third of seniors without drug insurance of any type, it's a lot better than nothing. You can't spend $60 billion a year and not please someone.
The latest evidence that the plan won't wreak havoc when it goes into effect next month comes from a Kaiser Family Foundation survey conducted with Hewitt Associates that was released yesterday. One of the other major charges against the Bush drug plan is that it would encourage companies that already provide drug insurance to their retirees to drop their plans in favor of the inferior government plan.
The survey asked 300 big companies with existing drug plans (nearly half of seniors have some type of insurance, usually from their former employers) whether they planned to drop coverage. Nearly 80 percent said no and would instead take advantage of a subsidy offered by the government to keep them in the game. Another 10 percent said they planned to shift their workers to Medicare but would subsidize their retirees. Only one in ten firms said they'd require their retirees to shift to the government plan.
That mild ripple will hardly be noticed. Unlike New York Times columnist Paul Krugman, who has attacked the Bush plan in a number of columns, and pollster Celinda Lake, whom I heard raise all the traditional objections at a Campaign for America's Future event last week, I predict that next fall no one will talking about prescription drugs as a political issue. The war in Iraq and a tottering economy will turn the high cost of drugs into a minor talking point at best.
That doesn't mean it isn't terrible policy. The Bush plan is the best price support program enacted by Congress since the last farm bill. According to my latest issue of the AARP Bulletin, drug prices rose at twice the rate of inflation last year, the fourth straight year they went up more than 6 percent. But the net effect of the drug plan is to substitute government payments for out-of-pocket senior expenditures to meet these rising costs.
That may be a stupid policy. It may bankrupt Medicare. But as long as millions of seniors' expenses are less at the end of next year compared to this year, it's unlikely to win many votes for Democrats that they didn't already have.
Posted by gooznews at December 8, 2005 02:57 PMRead your article w/ interest...i am a senior w/ no health insurance...my wife and I live on our SS checks...and a small pension. We are not enrolling in the Medicare Plan. The savings for us is only 30% to 35% max. also we have to pay the monthly fee.
Posted by: Roger Troop at December 9, 2005 09:45 AMWith oncology drugs accounting for about 69% of total Part B spending on prescription drugs and related services, the new Medicare Prescription Drug Plan Part D will even be more important for Senior cancer patients.
Beginning January 1, 2006, senior Americans with cancer may not even have to go to hospitals, let alone the infamous infusion-rooms of office-based oncology practices. That's because the new Medicare Modernizaton Act will offer them benefits they did not have before, such as coverage for oral chemotherapy drugs. If prescribed an oral-dose chemotherapy drug, you will be given a prescription that you will take to your local pharmacy to have filled, just like you normally do with all the other prescription medications that you may be taking. Because it is a pill, patients can take it at home with only occasional visits to the doctor or clinic.
Oral chemotherapy drugs are treating cancer effectively and enhance the quality of treatment for cancer. Compared to infusional therapy, oral-dose cancer drugs can make treatment more convenient for patients by allowing flexibility, without disrupting work or other activities. Taking your medication at home allows you the freedom to carry on with your daily life. This results in less time spent in hospitals and private oncology practices because of the absence of intravenous administration and its related side-effects.
These targeted cancer therapies will give doctors a better way to tailor cancer treatments. Treatments may be individualized based on testing the individual properties of each patient's cancer. These new differences in therapy hold the promise of being more selective, harming fewer normal cells, reducing side-effects, and provide a savings in health care costs.
If you have a private health plan which has a good prescription plan, in the vast majority of cases, you will want to continue in your plan. If you want to apply for the new Medicare prescription benefits, you may do that also. Oral chemotherapy will be handled the same as "infusion" chemotherapy by Medicare, but under plan D instead of plan B. However, if you can and want to utilize a lot of the generic or older drug agents, the cost would be significantly less. Most infusional therapies are typically biotechnology drugs made of complicated proteins that are injected. This makes them several times more expensive than traditional pill-form pharmaceuticals.